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Q. A patient with a fresh knee replacement has taken pre-medication Amoxicillin 2g. What antibiotic can be given for her tooth abscess?

Answered by
Dr. Vivek Chail
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 20, 2015 and last reviewed on: Jul 01, 2019

Hello doctor,

I have a patient with a fresh knee replacement, and of course takes premedication Amoxicillin 2g, one-hour pretreatment. She now has a tooth abscess, and I want to give her antibiotics. My thought is, since she has to always use Penicillin as a pre-medication, I would change the antibiotics.But she also has a colon resection, and Clindamycin probably would not be a good one to use. Can I give her Ciprofloxacin? Also, on her next appointment, should she go ahead and take the 2g of Amoxicillin as usual, or Ciprofloxacin or what can be used as a pre-medication? Thank you.

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Hello,

Welcome to icliniq.com.I have read through your query in detail. Please find my observations below.

  1. Amoxicillin is still a better antibiotic for a dental abscess as compared to other medicines. It is the first choice of medicine even for a dental abscess.
  2. It is better to continue with amoxycillin as a treatment option for her.
  3. Metronidazole or clindamycin is given only in case of severe infection.
  4. The order of preference of drugs for a dental abscess in a patient is Amoxicillin, Erythromycin or Clarithromycin or Clindamycin, and Metronidazole.
  5. Ciprofloxacin is usually not given at first.
  6. She can be given amoxicillin on her next appointment as well.

The above information is as per latest updates on pharmacological treatment of a dental abscess. Please keep in mind any allergy the patient might have to any of the medications and prescribe an alternative choice. Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.


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